Saturday, December 27, 2008

Took the words right out of my mouth...

Blagojevich says he is "on the wrong planet" if impeached. Well...duh!

Friday, December 26, 2008

Breast MRI and the Insanity of Progress

Let's start this blog on a happy note: cancer. My father-in-law recently died of it. Everyone fears it. But most of us will come down with it. I often wonder if the ancients were as troubled with cancer as we are. Probably not because nobody lived long enough to get it. Although cancer got it's name from the fungating tumors which developed in the female breast during ancient times. The complexity of taking care of sick people today knows almost no limit. Not too terribly long ago a simple abscessed tooth could lead to endocarditis and death. We are reminded that John Buford, cavalry hero of Gettysburg did not survive the war not because he was KIA but because he succumbed to a bad gallbladder. Which brings me to my point. The rage in breast surgery and somehting that may becoming the 'standard of care' is to stage breast cancer patients with a preop MRI. In a perfect world this may be a good thing. But sometimes no news is good news. We have been taking pretty good care of breast cancer patients before MRI. We need to start a randomized trial to see if the preop use of MRI and the resulting action it causes (like more biopsies, more mastectomies and rampant fear) result in better outcomes. If it does not, then not only will my fears be proven, but it may allow the headlong, and very expensive, pursuit of unrestrained medical advancement to start to come under meaningful control. wes